Cardiovascular Implications and Therapeutic Considerations in COVID-19 Infection
AbstractThe ongoing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has profoundly impacted all fields of medicine. Infection with SARS-CoV-2 and the resulting coronavirus of 2019 (COVID-19) syndrome has multiorgan effects. The pandemic has united researchers from bench to bedside in attempts to understand the pathophysiology of the disease and define optimal treatment strategies. Cardiovascular disease is highly prevalent and a leading cause of death across gender, race, and ethnic groups. As the pandemic spreads, there is increasing concern about the cardiovascular effects of the viral infection and...
Source: Cardiology and Therapy - June 12, 2020 Category: Cardiology Source Type: research
Extrapolation of Survival Benefits in Patients with Transthyretin Amyloid Cardiomyopathy Receiving Tafamidis: Analysis of the Tafamidis in Transthyretin Cardiomyopathy Clinical Trial
ConclusionsThis extrapolation of survival data from ATTR-ACT further supports the efficacy of tafamidis in patients with ATTR-CM. Owing to the limitations of this analysis, these survival estimates should be interpreted with caution; however, they are consistent with recently presented findings from a combined analysis of data from ATTR-ACT and interim data from an ongoing long-term extension study (median follow-up 36 months; ClinicalTrials.gov number NCT02791230).Trial RegistrationClinicalTrials.gov: NCT01994889. (Source: Cardiology and Therapy)
Source: Cardiology and Therapy - June 9, 2020 Category: Cardiology Source Type: research
In-Hospital Outcomes of Patients with Acute Decompensated Heart Failure and Cirrhosis: An Analysis of the National Inpatient Sample
ConclusionsAs the incidence and prevalence of ADHF and cirrhosis increases worldwide, we urge the medical community to increase surveillance of patients with both diseases and perform rigorous cardiovascular risk assessments as well to improve patient outcomes. (Source: Cardiology and Therapy)
Source: Cardiology and Therapy - June 7, 2020 Category: Cardiology Source Type: research
Anatomical Extent of Venous Reflux
This report addresses the most important aspects of the standard definitions of the anatomical extent of venous reflux, the differences between the three classes of reflux, and the challenges of implementing this classification in clinical practice. (Source: Cardiology and Therapy)
Source: Cardiology and Therapy - June 1, 2020 Category: Cardiology Source Type: research
A Qualitative Analysis of Patient-Related Factors Associated With Implantable Cardioverter Defibrillator Acceptance
ConclusionsPatients without ICDs perceived less benefit from ICDs and had less decision support. Participants viewed conversations with providers as insufficient. Needed interventions include the development and validation of processes for informed decisions about ICDs. (Source: Cardiology and Therapy)
Source: Cardiology and Therapy - May 30, 2020 Category: Cardiology Source Type: research
Acute Myocarditis After Black Widow Spider Bite: A Case Report
AbstractThe black widow spider (BWS) is a venomous spider whose bite can cause various clinical conditions that range from local damage to serious systemic complications, including death. Cases of myocarditis following a BWS bite are rare but they can be fatal on occasion. However, the prognostic significance of the bite and presentation of myocarditis is unknown. Our case involved a 50-year-old man who presented with myocarditis after being bitten by a BWS and subsequently admitted to the intensive care unit for cardiac monitoring. During the hospital stay, he showed worsening signs on both the electrocardiographic and ec...
Source: Cardiology and Therapy - May 26, 2020 Category: Cardiology Source Type: research
Perceptions and Experiences of Atrial Fibrillation Patients on Their Condition and Oral Anticoagulant Treatment
ConclusionsGPs and patients are waiting for the other to mention issues surrounding AF treatment such as switching, use of thrombosis service, and number of pills to take first. The perceptions and experiences of patients with AF regarding their disease and treatment highly influence the decisions GPs make, together with these patients, as well as considerations that patients have regarding their treatment; GPs need to be aware of their AF patients ’ perceptions and experiences with their condition and medication’ in order to facilitate discussions with patients and improve clinical outcomes. (Source: Cardiology and Therapy)
Source: Cardiology and Therapy - May 26, 2020 Category: Cardiology Source Type: research
Lipoprotein(a) and Cardiovascular Disease Prevention across Diverse Populations
AbstractLipoprotein(a) (Lp(a)) is a highly proatherogenic lipid fraction that is genetically determined and minimally responsive to lifestyle or behavior changes. Mendelian randomization studies have suggested a causal link between elevated Lp(a) and heart disease, stroke, and aortic stenosis. There is substantial inter-ethnic variation in Lp(a) levels, with persons of African descent having the highest median values. Monitoring of Lp(a) has historically been limited by lack of standardization of assays. With the advent of novel therapeutic modalities to lower Lp(a) levels including proprotein convertase subtilisin/kexin 9...
Source: Cardiology and Therapy - May 24, 2020 Category: Cardiology Source Type: research
Sex-Based Differences in Coronary and Structural Percutaneous Interventions
AbstractIn the current state of interventional cardiology, the ability to offer advanced therapies to patients who historically were not surgical candidates has grown exponentially in the last few decades. As therapies have expanded in complex coronary and structural interventions, the nuances of treating certain populations have emerged. In particular, the role of sex-based anatomic and outcome differences has been increasingly recognized. As guidelines for cardiovascular prevention and treatment for certain conditions may vary by sex, therapeutic interventions in the structural and percutaneous coronary areas may also va...
Source: Cardiology and Therapy - May 20, 2020 Category: Cardiology Source Type: research
Effectiveness of Trimetazidine in Patients with Stable Angina Pectoris of Various Durations: Results from ODA
ConclusionsAddition of TMZ 80 mg od to antianginal treatment was effective in reducing the frequency of angina attacks and the use of short-acting nitrates, improving Canadian Cardiovascular Society (CCS) class, self-reported physical activity, and adherence to antianginal therapy. These beneficial effects were observed in pat ient groups with different durations of stable angina, suggesting an opportunity for decreasing angina burden even in recently diagnosed patients.Trial RegistrationISRCTN registry Identifier, ISRCTN97780949. (Source: Cardiology and Therapy)
Source: Cardiology and Therapy - May 18, 2020 Category: Cardiology Source Type: research
The Physiologic Basis and Clinical Outcomes of Combined Impella and Veno-Arterial Extracorporeal Membrane Oxygenation Support in Cardiogenic Shock
AbstractVeno-arterial extracorporeal membrane oxygenation (VA-ECMO) provides effective hemodynamic support in cardiogenic shock, but in some cases may be complicated by left ventricular (LV) distension and pulmonary edema. The Impella, a catheter-mounted microaxial pump has been used to unload the LV. Recent studies have compared the clinical outcomes of VA-ECMO to the combination of Impella and VA-ECMO. The purpose of this review is threefold: firstly, to discuss the physiologic al effects of Impella support in addition to VA-ECMO, secondly to review published studies on the outcome of this combined support, and thirdly...
Source: Cardiology and Therapy - May 17, 2020 Category: Cardiology Source Type: research
Incidence Rates of Bleeding and Emergency Surgery Due to Trauma or Fracture Among Japanese Patients with Non-valvular Atrial Fibrillation Receiving Oral Anticoagulation Therapy
ConclusionsFewer than one in 200 patients per year with NVAF receiving OACs experience emergency surgeries and major bleeding episodes associated with fractures and trauma; however, the IR of these events is markedly higher in patients of advanced age.Trial registrationClinicalTrials.gov 207, NCT03254147. (Source: Cardiology and Therapy)
Source: Cardiology and Therapy - May 10, 2020 Category: Cardiology Source Type: research
Proposal for New Classification and Practical Use of Diuretics According to Their Effects on the Serum Chloride Concentration: Rationale Based on the “Chloride Theory”
AbstractCurrently, diuretic therapy for heart failure (HF) pathophysiology is primarily focused on the sodium and water balance. Over the last several years, however, chloride (Cl) has been recognized to have an important role in HF pathophysiology, as both a prognostic marker and a possible central factor regulating the body fluid status. I recently proposed a unifying hypothesis for HF pathophysiology, called the “chloride theory”, during HF worsening and recovery, as follows. Chloride is the key electrolyte for regulating both reabsorption of tubular electrolytes and water in the kidney through the renin–angiotens...
Source: Cardiology and Therapy - May 5, 2020 Category: Cardiology Source Type: research
Prevalence of US Adults with Triglycerides ≥ 150 mg/dl: NHANES 2007–2014
ConclusionsOver 12 million Americans are treated with a statin and have TG levels ≥ 150 mg/dl. Interventions such as icosapent ethyl that have been shown to reduce ASCVD event risk in this elevated TG population with type 2 diabetes or established ASCVD can provide substantial clinical benefit for these patients. (Source: Cardiology and Therapy)
Source: Cardiology and Therapy - April 22, 2020 Category: Cardiology Source Type: research
Diagnosis of Transthyretin Amyloid Cardiomyopathy
AbstractTransthyretin amyloid cardiomyopathy (ATTR-CM) continues to be an easily overlooked, life-threatening, yet treatable cause of heart failure. Furthermore, its elusive diagnosis leads to late or misdiagnosis. As therapeutic advancements such as tafamidis usher in a promising new era in the management of ATTR-CM, the need for disease awareness and efficient diagnostic evaluation is crucial. With newer inexpensive imaging modalities and techniques, such as longitudinal strain imaging, T1 mapping on cardiac magnetic resonance imaging, and cardiac scintigraphy, the diagnosis of ATTR-CM no longer requires invasive evaluat...
Source: Cardiology and Therapy - April 6, 2020 Category: Cardiology Source Type: research
